Contrave combines two well-known medications—naltrexone and bupropion—into one extended-release tablet designed to support chronic weight management. Approved by the FDA since 2014, it targets brain pathways involved in hunger and reward to help reduce appetite and curb cravings for high-calorie foods. It’s prescribed for adults with obesity or those overweight with related health issues.
This approach differs from many other options because it focuses on the brain’s response to food rather than just slowing digestion or boosting metabolism directly. When paired with a reduced-calorie diet and regular physical activity, it helps many people achieve and maintain meaningful weight loss. Results vary, but consistent use often leads to noticeable improvements in eating habits over time.
Doctors recommend Contrave as part of a broader plan, not a quick fix. It requires gradual dosing to minimize side effects and close monitoring to ensure it fits individual needs. This article explores how it works, what to expect, and key considerations for safe, effective use.
What Is Contrave and Who Is It For
Contrave contains naltrexone, an opioid antagonist, and bupropion, an antidepressant that also aids smoking cessation. Together they form a unique combination approved for long-term weight control. It’s taken orally as extended-release tablets.
The FDA approves it for adults with a BMI of 30 or higher, or 27 and above with at least one weight-related condition like hypertension, type 2 diabetes, or high cholesterol. It’s not intended for cosmetic weight loss or short-term use alone.
Patients must commit to lifestyle changes for best outcomes. Regular follow-ups help assess progress and adjust the plan. This makes it suitable for those who’ve struggled with diet and exercise without sufficient results.
How Contrave Works in the Body
Contrave influences two main brain areas: the hypothalamus, which regulates hunger and fullness, and the mesolimbic reward system, linked to pleasure from eating. Bupropion increases dopamine and norepinephrine activity to enhance satiety signals.
Naltrexone blocks opioid receptors, reducing the rewarding feel from overeating and preventing feedback that might increase cravings. This dual action helps people feel satisfied with smaller portions naturally.
The combination promotes better control over emotional or habitual eating. It doesn’t suppress appetite dramatically like stimulants but supports gradual, sustainable shifts in behavior. Effects build over weeks with consistent use.
Contrave Medicine for Weight Loss | Key Details and Expectations
Many users experience reduced hunger and fewer intense cravings, making it easier to stick to calorie goals. Clinical trials show it helps achieve 5% or more body weight loss in a significant portion of participants when combined with diet and exercise.
Average losses range from 5% to 9% of starting weight over a year, depending on adherence and individual factors. Some see 12-18 pounds dropped, while others experience more modest changes. Progress often plateaus after initial months but can continue with maintenance.
If at least 5% loss isn’t seen after 12 weeks on the full dose, doctors typically recommend stopping, as continued benefit is unlikely. This checkpoint ensures the medication provides real value without unnecessary risks.
Dosing Schedule and Administration
Start with one tablet in the morning during week one to allow adjustment. Week two adds an evening tablet for a total of two daily. By week three, increase to two in the morning and one in the evening.
Reach the maintenance dose of two tablets twice daily—32 mg naltrexone and 360 mg bupropion—starting week four. Take with food but avoid high-fat meals to prevent excessive absorption.
Swallow tablets whole without crushing or chewing. Consistency matters for steady blood levels. Providers guide titration and monitor for tolerance throughout.
| Week | Morning Dose | Evening Dose | Total Daily (Naltrexone/Bupropion) |
|---|---|---|---|
| 1 | 1 tablet | None | 8 mg / 90 mg |
| 2 | 1 tablet | 1 tablet | 16 mg / 180 mg |
| 3 | 2 tablets | 1 tablet | 24 mg / 270 mg |
| 4+ | 2 tablets | 2 tablets | 32 mg / 360 mg |
Expected Weight Loss Results
In major trials, about 36-57% of users achieved at least 5% weight reduction compared to 17-43% on placebo. Non-diabetic participants often lost around 5-8% body weight over 56 weeks.
Those with type 2 diabetes saw slightly lower averages, around 2-5%, but still meaningful for health improvements. Losses were 2-4 times greater than diet and exercise alone in many cases.
Real-world results depend on factors like starting weight, diet quality, and activity level. Higher adherence correlates with better sustained outcomes. Track progress monthly with professional support.
Common Side Effects and How to Manage Them
Nausea affects about a third of users early on, often easing after weeks. Constipation, headache, and vomiting rank next in frequency. These gastrointestinal issues improve with smaller meals and hydration.
Other effects include dizziness, insomnia, dry mouth, and fatigue. Starting low and increasing slowly helps the body adapt. Over-the-counter remedies may relieve mild symptoms under guidance.
Most side effects are mild to moderate and decrease over time. About 24% discontinued in trials due to issues, mainly nausea. Persistent problems warrant dose adjustment or reevaluation.
Serious Precautions and Who Should Avoid It
Contrave carries a boxed warning for increased suicidal thoughts, especially in younger adults or those with mood disorders. Monitor mood changes closely and report any concerns immediately.
Avoid if using opioids, as naltrexone blocks their effects and risks withdrawal. Contraindicated in uncontrolled hypertension, seizure disorders, eating disorders like bulimia, or recent MAOI use.
Elevated blood pressure or heart rate can occur, particularly early on. Regular checks are essential for those with cardiovascular risks. Not recommended during pregnancy, breastfeeding, or in children.
Liver concerns or glaucoma require caution. Inform providers of all medications to prevent interactions. Comprehensive screening precedes starting treatment.
Lifestyle Integration for Optimal Results
Pair Contrave with a balanced, calorie-reduced diet emphasizing whole foods, vegetables, and lean proteins. Focus on portion control to align with reduced cravings.
Aim for at least 150 minutes of moderate exercise weekly, mixing cardio and strength training. Activity boosts metabolism and supports muscle preservation during loss.
- Drink plenty of water to ease constipation and nausea.
- Eat fiber-rich foods for digestive health.
- Prioritize sleep to support mood and appetite regulation.
- Track meals and triggers in a journal for awareness.
Build habits gradually for long-term success. Celebrate small wins like better energy or looser clothes. Professional coaching or support groups enhance motivation.
Comparison to Other Weight Loss Medications
Contrave offers an oral option targeting brain reward pathways, unlike injectables that mimic gut hormones. It suits those preferring pills over shots.
Average weight loss tends to be lower than newer GLP-1 agents but remains clinically meaningful for many. Cost and accessibility vary, with Contrave often more affordable long-term.
Side effect profiles differ; Contrave has more neurological risks but fewer injection-site issues. Choice depends on health profile, preferences, and provider recommendation.
Summary
Contrave provides a targeted approach to weight management by reducing cravings and appetite through its naltrexone-bupropion combination. FDA-approved for adults with obesity or overweight plus comorbidities, it delivers 5-9% average body weight loss over a year when used with diet and exercise. Titrate dosing carefully, monitor for side effects like nausea or mood changes, and evaluate progress at 12 weeks.
Success relies on lifestyle commitment and medical oversight. It offers reliable support for sustainable changes rather than dramatic rapid loss. Discuss with a healthcare provider to determine if it aligns with personal health goals.
FAQ
How much weight can you lose on Contrave?
Users typically lose 5-9% of body weight over 56 weeks in trials, equating to 12-18 pounds for many. Results vary by adherence to diet, exercise, and individual factors. About 40-57% achieve at least 5% loss versus lower rates with placebo alone.
Is Contrave FDA-approved for weight loss?
Yes, the FDA approved Contrave in 2014 for chronic weight management in adults with BMI 30+ or 27+ with weight-related conditions. It’s used alongside reduced-calorie diet and increased activity. Discontinue if 5% loss isn’t met after 12 weeks on full dose.
What are the most common side effects of Contrave?
Nausea, constipation, headache, vomiting, dizziness, insomnia, and dry mouth occur frequently, especially early. Most improve with time and gradual dosing. Gastrointestinal effects often lead to discontinuation if unmanaged.
How does Contrave compare to Wegovy or Ozempic?
Contrave is an oral pill targeting brain reward and hunger centers, while Wegovy and Ozempic are weekly injections mimicking GLP-1 for greater average loss (often 15%+). Contrave may be more affordable and suit pill preference, but injectables generally produce stronger results.
Who should not take Contrave?
Avoid if on opioids, with uncontrolled seizures, eating disorders, recent MAOI use, or certain psychiatric risks due to suicidal ideation warning. Pregnant or breastfeeding individuals, those with severe hypertension, or glaucoma need alternatives. Always consult a doctor for personalized screening.
Dr. Hamza is a medical content reviewer with over 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic conditions. His reviews are grounded in trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Hamza is intended for educational purposes and is not a substitute for professional medical advice.